الفهرس | Only 14 pages are availabe for public view |
Abstract Ovarian cancer is the fourth most common cause of cancer related to death in women and is the seventh most common cancer. About 70% of ovarian cancer cases are diagnosed at an advanced stage, and only 30% of women with such cancers can survive up to 5 years. About 90% of primary malignant ovarian tumors are epithelial and are thought to arise from the ovarian surface epithelium or from surface epithelial inclusion cysts. The rest are sex cord-stromal tumors and germ cell tumors. Serous tubal intraepitheial carcinoma (STIC) is a novel tumor in which we thought that adnexal tumor may arise from fimbria of fallopian tube. This is diagnosed with sectioning and extensive examination of fimbrial end of the tube. Cancer ovary may present with vague symptoms and commonly presents in advanced stage. We start investigations with ultrasound using IOTA simple descriptors, IOTA simple rules and IOTA ADNEX Model. Then, we perform CT staging including chest, abdominal and pelvic to exclude distant metastasis. After that, tumor markers are withdrawn. Of these tumor markers, CA 125 is still the most important one. We use it in assessment of risk of malignancy index and in IOTA ADNEX Model to give us percentage of malignancy of ovarian lesion. Treatment of cancer ovary include either surgical staging or cytoreductive surgery. In both procedures, Peritonectomy is an important component in surgical treatment for ovarian malignancies. In this procedure, we take multiple random peritoneal biopsies from the peritoneal cavity and then remove both right and left paracolic peritoneal gutters and send them to Lab of Pathology to show which one, random or total, give us higher rate of detection of tumor deposits. Also, we compared between both procedures regarding timing, technique, post operative complications. In addition, these peritoneal implants revealed two types; invasive and non-invasive. Three criteria were depicted for diagnosis of invasive implants ; invasion of underlying normal tissue, micropapillary architecture, and solid epithelial nests surrounded by clefts. Non-invasive peritoneal implants may show papillary core with psammoma bodies lined by epithelium with loose adherence to adjacent fibro fatty tissue without invading the surrounding structures |